The first part of this series covered what was said in the Foreword and Intro of Hull City Council‘s Corporate Plan. The second part covered the section about ‘Earning’, which is more business and employment related. The third part covered ‘Learning’, which is more about formal education and makes some points about teaching kids how to take care of themselves. This part covers health and wellbeing issues for all people in the Hull City Council area. All of these specific areas were created by OneHull (a Local Strategic Partnership) as part of the Sustainable Community Strategy, which gives the Council some structure to build upon and make specific targets.
“More than 50 separate nationalities and cultures are now represented in the city, and older people from all Hull’s communities will be supported through this new plan. 46% of local people in their 50s have a long term illness compared with 80% for people aged 85 or more. More than 15% of households in the city are made up of pensioners living alone.”
Basically, this (from page 14 of the plan) means that the younger generations are getting progressively worse in terms of health. So, as well as making today’s older people healthier and more able to take care of themselves, there also has to be preventative measures so that future generations are healthier.
Another key part of this section is living conditions. Suitable housing can improve health and be part of a good quality of life (wellbeing) This section is also called ‘Health & Wellbeing’, hence the inclusion of housing issues.
Key Improvement Targets
The following are the Council’s targets for this area:
- Increase the number of vulnerable people who are supported to maintain independent living in their own homes
- Increase the average SAP (Standard Assessment Procedure) rating in local houses, to keep them warm and energy efficient
- Decrease the numbers of Council homes that do not meet the Decent Homes Standard
- Increase the number of people receiving Direct Payments to choose their own care support
- Increase the numbers of people receiving telecare/digital technology support
- Strategically plan, commission and develop services in partnership with other agencies
- Ensure current traditional services are transformed, and new services take account of developments in technology and best practice across the UK
The LAA targets (see page 23 of the Corporate Plan and here) show that the percentage of people in vulnerable categories who are supported to maintain independent living in 2007/2008 is 98.1%. The target for 2010/2011 is 99.2%. This is a high percentage, but there is still room for improvement. In the Appendix to the Head of Executive report from November 2010, we can see that in the first quarter of 2010/2011, the percentage is 99.26%. This means they’ve beaten their target and we can assume that the figure will be slightly higher in Q2 (when that appendix was released, the data wasn’t available).
The SAP rating is all about energy efficiency in homes and goes from 1 to 100 (100 being the best rating). As of September 2010, the average SAP rating for England was 79.3. The 09-10 target for Hull was 70%, compared to the baseline figure of 60% in 2005/2006. According to the Appendix document, the ‘actual’ figure for 2009/2010 was ‘static’, which is a clear failure. There has been no target set for 2010/2011 and even if they had achieved the 2009/2010 target, the Council would still be significantly behind the national average.
Details of the Decent Homes Standard can be found here. The baseline figure for Hull is 50% (2007/2008). The target for 2010/2011 is an ambitious 0% (which would mean there is no Council homes that could be classed as ‘non decent’). The second quarter percentage for 2010/2011 is 14.2%, which is ahead of the target for that specific quarter and means that they could still achieve the LAA target. Nationally, 16% of Council homes in England (see page 10 of linked document) were ‘non decent’. Just under 15% of 16% is low.
Unfortunately, there are no LAA targets for the remaining four bullet points. This makes it difficult to assess whether anything has been achieved. You’ll also notice that there are no Key Improvement Targets that are directly related to health, even though this is the ‘Healthy/Health & Wellbeing’ area of the plan.
Changing for the better
There were some more specific point in the ‘Healthy’ section which attempted to explain how the targets will be achieved:
- Invest over £132M into the Decent Homes Programme to improve the quality of Hull’s Housing, and £22M to support vulnerable people to continue living in their own homes
- Pilot and implement Individual budgets, enabling people to manage their own social care provision, including use of the resource allocator system for young people in transition and for those receiving direct payments
- Develop Day Care Services that are modernised to meet the challenge of care service transformation and support socially excluded groups more effectively
- Work with Hull PCT and others in producing a joint strategic needs assessment, in order to develop a strategic joint commissioning strategy to include use of incentives, and market levers
- Expand the use of adult placement schemes to support people with complex needs to live with a greater degree of independence, but in a family friendly environment
- Work with partners to ensure that Telecare is available to all customer groups
- Implement a Health Education Programme to support businesses and improve levels of preventative advice
This first point is worth investigating due to the changes to DCLG and local government finances. According to this document, the government are still going to invest £2bn in the Decent Homes Programme. Hopefully, most (if not all) of the Council investment will remain.
As for the other points in the above list, the lack of LAA targets makes assessment difficult.
Despite there being no LAA targets in the Corporate Plan, there are some targets in the previously mentioned Appendix document (pages 15 and 16). Not all of those targets cover the remaining points above, but it’s better than nothing. What is pleasing is the inclusion of targets directly related to healthcare.
The first of these targets aims to reduce the amount of hospital admissions that are to do with alcohol related harm. The baseline figure for 2006/2007 is 1821 per 100,000. The actual figure for 2009/2010 was 1993 – a clear failure. Bizarrely, the target for 2010/2011 is 2364. If ‘smaller is better’ in this case, why set a target that is higher than the actual figure for the previous 12 month period? The document states that they are ‘on track’ to meet the 09/10 target, but that target isn’t goven, so the reader can’t make a proper assessment. They should be looking to meet the most recent target though and it should be much lower that 2364 per 100,000.
The next target is about reducing mortality rates from circulatory diseases at ages under 75. There was 111 per 100,000 in 2006 and the target for 2010/2011 is 87.7. It’s good that they’re aiming for a lower figure, but the Appendix provides no data to make a proper assessment.
The Council also aims to reduce the number of women smoking during and after pregnancy. The baseline figure from 2005/2006 is 29%. In 2009/2010, the actual figure was 23.1% and that is good news. However, the 2010/2011 target is 24% and as of Q2, the actual figure is 24.4%. So, not only have they not met their target, but they have also set one which is higher than a previous period, even though they should be aiming for something lower.
Then there is a target about the amount of perople losing a minimum of 5% bodyweight. The baseline for 2005/2006 is 100, but the actual figure in 2009/2010 was 11, which is terrible and shows no progress at all. There is also no target stated for 2010/2011 and a distinct lack of data. This information was produced from a scheme/survey using a select group of participants, so this isn’t a figure that represents all of the people in Hull. However, it is still worrying.
The target about reducing the martality rate from all cancers at ages under 75 suffers from a lack of data. However, we can see that the actual 2008 figure was 145.66 per 100,000 people. This is an improvement compared to the 2006 figure of 150 per 100,000, which is definitely good news.
Finally, there was a target to increase the number of people quitting smoking. The baseline figure is from 2005/2006 and was 2172. The target for 2010/2011 is 3500 and in Q1, we see a figure of 987. Assuming that the other three quarters have similar results, they will either achieve their target or beat it.
Summary & Conclusion
So, we have a Corporate Plan that features no Key Improvement Targets or LAA targets directly related to healthcare. The targets for that do exist but are in an Appendix document that can only be found by looking through previous minutes of City Council meetings. Whilst some of those healthcare targets have been achieved, there are some which suffer from a lack of data and other where the figures that are desired are simply bizarre.
As for housing related targets, the Council have achieved what they wanted to by increasing the number of people in vulnerable groups who can experience independent living. However, they are performaing incredibly poorly when it comes to energy efficiency in Council properties. Despite this, the general standard of Council homes is improving dramatically.
Overall, there is a very mixed set of results (the Council should be pleased with the targets it has met though), bizarre choices for some targets and a distinct lack of data in some areas.
So, what do you think?